Discussion of public health and health care policy, from a public health perspective. The U.S. spends more on medical services than any other country, but we get less for it. Major reasons include lack of universal access, unequal treatment, and underinvestment in public health and social welfare. We will critically examine the economics, politics and sociology of health and illness in the U.S. and the world.

Friday, December 16, 2005

PLoS

As long as we're doing initials . . . PLoS stands for Public Library of Science. At the blogger panel in Philadelphia, I mentioned that I'm often frustrated because I can't link to subscriber-only journals. Audience members had a good deal to say about this subject.

The way it works now, new scientific knowledge is generated (for the most part) in universities, which are then required to give it away free to scientific publishers, who sell it back to them at exorbitant prices that the general public, and even most public libraries, can't afford. (Subscriptions to scientific journals cost hundreds of dollars a year.) As a matter of fact, even university libraries in less wealthy countries can't afford to subscribe to many journals, although some publishers have started to offer discounts to subscribers in poor countries.

To be sure, few non-specialists are interested in reading the sorts of highly technical reports on the latest, typically very narrow findings in physics, biology, or biomedicine that make up the bulk of scientific publication. However, journals of medicine and public health have a great deal of material on public health and health policy that would indeed be of interest, and accessible to, literate lay people, if they could get their hands on them. (One thing you can do is subscribe to Scientific American, which will keep you up to date on the broad range of scientific endeavor.)

A fairly new project, the Public Library of Science, makes academic science free to all by posting its journals on the world wide web. It's financed by the authors, but its still peer-reviewed -- you don't get published just because you pay. PLoS Medicine is the one that's relevant here. For example, Here is an interesting article by Lacasse and Leo about SSRIs. Contrary to the popular mythology, which is pushed heavily by the drug companies in their advertising as fact, there is no good evidence that depression, or any of the other newly invented diseases for which SSRIs are prescribed, is caused by a "deficiency" of serotonin, or any other specific "chemical imbalance" in the brain. Why anti-depressants work, to the extent they work at all (which is not much, at best) is completely unknown.

A librarian in the audience also suggested that many public libraries subscribe to services that make a range of journals available on-line, so you might want to try your public library if you're interested in that. But I want to make my sources readily available here, so I'll be turning to PLoS Medicine again in the future, I'm sure.